A more holistic view of health with sociology, psychology on the MCAT

The new MCAT has sections on sociology and psychology and this has led to new patterns of study:

The test has been thoroughly revamped and is now three hours longer. It takes 7 1/2 hours to complete, including breaks, and covers four new subjects, including a combined section on psychology and sociology that account for a quarter of the overall score.

Test takers will now have to define terms like “institutional racism” and “social constructionism,” and answer applied questions about how race and class affect health…

“Whether or not someone becomes ill has a lot to do with the society in which they live,” says Catherine Lucey, vice dean of education at University of California, San Francisco School of Medicine and a member of the committee that will assess the new MCAT…

How those conditions are treated has also evolved. Doctors know how to treat acute infection now. But managing chronic disease has become a much bigger part of medical care, and doctors need to develop different skills and a different kind of relationship with the patient. Doctors need to build trust, Lucey says, to understand how patients think and make decisions, in order to convince them to exercise more and change their diet.

For those in the comments who think that this is injecting liberal and untrue social science into the practice of medicine, there is plenty of evidence from a variety of fields that medical conditions are not solely dependent on physical traits or conditions. If you want to treat the whole patient, you need some knowledge of the patient’s social and mental well-being.

All that said, it will still be interesting to see whether this affects future doctors. Taking one class in sociology and psychology or looking at study materials on this subject doesn’t necessarily mean the principles will stick if med school programs don’t say much about these topics or knowledge in other areas is more incentivized.

Update on sociology becoming part of the MCAT in January 2015

ASA’s Footnotes for December 2012 includes an article with more details on sociological material being included on the MCAT in upcoming years:

An important change in the MCAT® (the Medical College Admission Test) has the potential to have a significant impact on sociology departments across the country. In February 2012, the Association of American Medical Colleges (AAMC) “approved changes… that will require aspiring doctors to have an understanding of the social and behavioral sciences.” (Mann, 2012). The new version of the test, which will be in place by January of 2015, includes an entire section on the social and behavioral sciences. One implication of this change is that pre-medical curricula across the country may start requiring that students take an introductory sociology course (as well as an introductory course in psychology) in preparation for taking the MCAT (see, for example, Brenner and Ringe 2012)…

The exact content of sociology and psychology test questions is not yet finalized. Starting in January 2014 the new social science section of the MCAT will be included as an “optional” section. The cohort of students who take that first updated version of the MCAT are already enrolled in college. Students who choose to complete it will be compensated in some way. These trial runs will be used to modify the section before it “counts” as part of the MCAT score. Starting in January 2015 the test will include the required section on social and behavioral sciences.

The new section of the MCAT that tests sociology and psychology is described in a Preview Guide to the MCAT2015 Exam. The descriptions contained in that guide detail specific content areas within sociology (including “understanding social structure,” “demographic characteristics and processes,” “social stratification,” and “social inequality”) that will be covered on the test (AAMC 2012:12).

Two quick thoughts:

1. I’ve mentioned this change in my Intro classes a few times and I think some pre-med students were aware of what was happening. I can’t say for sure that I’ve had an uptick in students interested in medical fields but this article suggests this could happen in coming years.

2. While I think this makes a lot of sense for medical practitioners to have some knowledge of society and social life, I am amazed at times that more fields don’t explicitly train their students or ask them to take classes in social life. For example, isn’t business often about interacting with people as well as managing employees? Wouldn’t sociology provide insights into this?

The sociology knowledge you need to take the MCAT

I noted last year that the MCAT, the exam for applicants to medical school, was changing to include knowledge about sociology. Since then, I have been curious about what exact sociological knowledge is required for the exam and a report from the American Association of Medical Colleges provides some insights. Here is “Behavioral and Social Science
Learning Outcomes at Graduation” that sociology (and psychology) can fulfill (p.24 of the document):

Accurately describe how social determinants of health influence health outcomes and how physicians can incorporate this knowledge in the care of patients.

Here is how a sociological vantage point can help deal with a particular scenario (p.16):

A woman newly diagnosed with breast cancer is searching for a physician to help her think through her situation, set goals, and develop a “health strategy.” While waiting to meet with a new physician for consultation, she tells a medical student that she has been mostly receiving “treatment options,” instead of health strategies…

• How do we conceptualize the difference between a “health strategy” and “treatment options”?
• How is the care of a cancer patient embedded in a network of friends, family, and health care providers?

And here is a more broad statement about what the social sciences can bring to medicine (p.10):

Given the daunting breadth of behavioral and social science, the contributions from this family of sciences can best be understood by attending to three core areas: 1) the use of behavioral and social sciences theory, 2) behavioral and social science research methods, and 3) core behavioral and social science concepts and contributions to the fund of medical knowledge.

On the whole, it seems like sociology is meant to help doctors and health care providers understand the social and cultural context of the patient. Added to an expanded matrix of care, sociology helps provide a more holistic approach to medical care.

It seems like these requirements could be fulfilled by an Introduction to Sociology course though without seeing the particular questions on the MCAT, it is hard to know.

Adding sociology to the MCAT

I’ve wondered recently about sociology in grade schools and here is news that sociology has been added to the MCAT, the entrance exam for medical schools:

The 2015 change marks the fifth major alteration of the MCAT since it was introduced in the 1920s.

The new MCAT will include the addition of an entirely new section titled “Psychological, Social and Biological Foundations of Behavior,” as well as a more intense examination of the biomedical sciences, such as genetics and biochemistry…

Koetje said the addition of psychology and sociology to the test was necessary because of the advances made in health care as well as the sociocultural changes within the health care system.

“Patients are more complex today, and medical schools have to ensure that these students will be capable of treating the whole person and everything that comes with that,” Koetje said.

As the article hints at, will more schools now have pre-med students take courses in sociology and psychology in order to prepare? In response to this question (part of a larger set of FAQs about the change), here is what the AAMC says:

Examinees who would not otherwise take biochemistry, cellular and molecular biology, introductory psychology, and introductory sociology would need to study the concepts tested. We do not anticipate the need for additional coursework in research methods and statistics.

I wonder exactly what sociological concepts will be included on the test. I assume race, social class, and gender are non-negotiable?

This also gives sociology teachers more room to tell undergraduates in Intro to Sociology classes that sociology is helpful for many fields, including medicine.